Fido’s little helper
WHAT could be wrong with Shadow? The green-eyed, long-haired cat had adapted well to his Santa Monica home. There was a carpeted cat tree in the living room for his climbing pleasure. He appeared to have reached an understanding about sharing the house with the other resident feline.
Then one day his owners saw wet spots around the house: Shadow was urine-spraying. The door was a favorite target. So was the side of the sofa. And a corner wall of the living room.
Not to be confused with eschewing the litter pan, spraying is a ritual of territorial marking that cats sometimes do whether they are spayed or neutered -- as Shadow is -- or not.
Shadow’s keepers, Fernanda Gray and Elliot Goldberg, were distressed. Pet ownership, they believe, is a trust not to be betrayed. “I don’t throw animals away,” said Gray, who with her husband now owns three cats.
But Shadow’s spraying had tested the couple’s resolve. They had to replace draperies, carpeting and the sofa. Their veterinarian was running out of ideas to discourage Shadow’s habit.
Then Gray saw a small newspaper ad in 2001: “Spraying Cats Needed for Study.” Shadow was accepted into a double-blind study of an undisclosed medication’s effect on the behavior.
Fourteen days later, the spraying abruptly stopped.
The drug was Prozac. Five years later, Shadow is still taking the medication -- half a 10-milligram tablet once a day -- in its generic form, fluoxetine, a $16 supply of which lasts about four months.
“He’s still active, he’s still his hyperactive self,” Gray said. “But it just takes that anxiety away.”
THEY are the new “Prozac Nation”: cats, dogs, birds, horses and an assortment of zoo animals whose behavior has been changed, whose anxieties and fears have been quelled and whose owners’ furniture has been spared by the use of antidepressants. Over the last decade, Prozac, Buspar, Amitriptyline, Clomicalm -- clomipromine that is marketed expressly for dogs -- and other drugs have been used to treat inappropriate, destructive and self-injuring behavior in animals.
It’s not a big nation yet. But “over the past five years, use has gone up quite a bit,” said veterinarian Richard Martin of the Brentwood Pet Clinic in West Los Angeles. Half a decade ago, no more than 1% of his patients were on antidepressants. Now, Martin estimates that 5% of the 8,000 cats and dogs seen at the clinic are taking drugs for their behavior.
The use of antidepressants is another example of the growing sophistication of medical care available to animals and willingly financed by owners who see pets as cherished companions. For these owners, drug therapy is not just another indulgence like Louis Vuitton carriers and day spas for the pampered pet. In their eyes, medication is urgent. Indeed, the new Prozac Nation is not populated with the worried well of the animal kingdom; it’s filled with animals behaving so badly they’re in danger of being cast off to a shelter and, possibly, a death sentence.
“If you have a cat that sprays constantly, that’s not a cat you’re likely to keep,” said Elyse Kent, the veterinarian who owns the Westside Hospital for Cats. “We were compelled to try these behavioral modification drugs.”
Kent has been treating cats with psychoactive drugs, mostly for spraying or aggression, for 12 years. After a UC Davis study published in 2001 showed that fluoxetine reduced feline spraying -- and following the success of Kent’s patient, Shadow, in a Prozac trial -- Prozac became a frequent choice at her clinic.
“I’d say twice a week, someone comes in to get a prescription for Prozac or fluoxetine or clomipromine,” said Kent, who nonetheless estimates that at any one time only 1% of her practice’s 3,000 patients are taking a psychoactive drug. (“Six weeks to three months is the average” length of treatment, she said.)
Veterinarians who prescribe psychoactive drugs insist they are not Dr. Feelgoods for the animal set. They do medical work-ups on animals, they say, to rule out physical causes for destructive or neurotic actions and prefer to use behavior modification instead of -- or, at least, along with -- drug therapy. Sometimes they have to deflate the expectations of owners eager to place their pets on antidepressants.
“I tell people if I had a magic pill, I would give it to them,” said veterinary behaviorist Karen Sueda, who works at the VCA West Los Angeles Animal Hospital. “In most cases when we give medication, it is not going to be a quick fix.”
Said Curtis Eng, chief veterinarian of the Los Angeles Zoo: “My feeling is they are a useful tool -- one of many -- to decrease stress and anxiety on an animal. If you can relieve the stressors through a behavior management program, I would much rather do that. But sometimes you need a little extra help to get them over that hump.”
When the zoo was coaxing a male orangutan, Minyak, back to respiratory health and enough energy for mating, veterinarians consulted with a psychiatrist and put the primate on the antidepressant Remeron.
“He was put on it for depression,” said Eng, who noted a beneficial side effect: Miknyak hadn’t been eating well and the drug increased his appetite. The orangutan bred successfully, fathering a healthy baby in 2005, and he is being weaned off the antidepressant.
THE drugs administered to animals fall mainly into two classes of antidepressants commonly prescribed to humans: selective serotonin reuptake inhibitors (SSRIs) and tricyclics.
Both groups control the levels in the brain of serotonin, a neurotransmitter that is believed to affect mood, depression and anxiety. The tricyclics also work on other neurotransmitters, including norepinephrine, which is thought to affect attention and impulsiveness.
In most cases, the drugs are being administered off-label, meaning they have not been put through the trials required for FDA approval for use in specific animals. (The Food and Drug Administration regulates drugs for both animals and humans.)
Clomicalm, a tricyclic manufactured by Novartis, is the only antidepressant approved by the FDA for dogs as a treatment for separation anxiety.
Veterinarian Scott Huggins, manager of technical marketing for Novartis, maker of Clomicalm, said that dogs are not intended to stay on it for life. “We don’t have specific studies on long-term use,” said Huggins, adding, “I do know it happens.”
In general, vets prefer to taper their patients’ use of the drugs. “We try to use these medications short-term,” said Kent. “Because they are not without side-effects.”
Antidepressants are believed to work on animals’ brain chemistry the same way they do on humans’. The difference is that veterinarians will not say they are treating clinical depression; many don’t believe an animal can be clinically depressed.
“A lot of the outward manifestations -- decrease in appetite, trouble sleeping, not taking joy in activities -- are there in dogs and cats,” Sueda said. “But you can’t ask a dog or cat, ‘Are you despondent?’ ”
But veterinarians will say that animals experience anxiety. Dogs with separation anxiety can bark endlessly, destroy household furniture, gnaw through fences or even fling themselves out of windows after owners leave. Birds have compulsively plucked themselves to partial baldness. Troubled cats maul their owners, hide for hours or refuse to use their litter boxes.
Bob Stewart, now the sole owner of a cat since his companion, Anne Marie Schmitt, died of cancer, recalls how his otherwise mellow feline would turn into a leopard-like creature. At one point, when Serendipity clawed Schmitt’s arm badly enough to send her to the hospital, Stewart says they considered drastic action. “If we could not have gotten her controlled, as much as we loved the cat, we probably would have had to find a way to get her adopted or send her to one of these shelters,” said Stewart, a retired game show producer who created the original “The Price is Right” and “Password.”
The owners refused to have the cat declawed. Instead, for the last several years, a daily dose of “triple fish-flavored” fluoxetine has, for the most part, quashed Serendipity’s desire to practice her hunting skills on humans.
“I thought it made sense,” said Stewart, sitting in his apartment with Serendipity resting nearby. “They feel pain as we feel pain. They feel happiness as we feel happiness. I didn’t question the idea that a drug could change the persona of an animal.”
As with humans, choosing the right drug and dosage for an animal is a process of trial-and-error. “A lot of behavior treatment is an art,” Sueda said.
No one knows that better than Amy Weber, who adopted Sam, a spayed female dog, 10 years ago. The Labrador/beagle mix appears sweet-natured and calm as she lies in the living room of the rambling Beechwood Canyon home Weber shares with her partner, Wendy Schwartz, and five pets. The couple’s other dog, Scout, busily scouts for affection. A hulking orange cat, Stripper, saunters by, pausing to swat Sam. The action elicits a gasp from the humans but only a quizzical look from Sam.
For several years, Sam was anything but calm when her owners left the house. She scratched doors, chewed through washing machine hoses and gnawed the wood trim on windows, sometimes cutting her mouth. If she was left outside, she either dug her way out of the yard or ripped through wire fences, scratching her head in the process.
Weber tried Clomicalm, tranquilizers, homeopathic remedies and Cesar Millan, the “Dog Whisperer.” But Sam’s separation anxiety defied all drugs and therapy for a time.
Although Weber, who edits movie trailers, put together a nearly full-time schedule of sitters and walkers for Sam, that didn’t stop the dog from going into a frenzy if Weber and Schwartz went out for the evening.
Then Weber hired Sueda, who put Sam on a regimen of Amitriptyline during the day and recommended Xanax at night if the couple wanted to go out. And she started the dog and her owners on a behavior training program.
(There are only 42 board-certified veterinary behaviorists in the world, according to Melissa Bain, chief of behavior service at the teaching hospital at the UC Davis School of Veterinary Medicine. Technically, Sueda is not one of them -- she hasn’t taken her boards yet -- but she is, practically speaking, L.A.'s veterinary behaviorist.)
“I never look at medication as a cure-all -- just like with people,” said the veterinarian, who delves into the history of each animal’s situation.
Appointments with Sueda aren’t cheap. A package of two lengthy visits -- the first is two hours -- follow-up phone calls and e-mails is $550, not counting what Sueda charges if she travels to the owner’s house.
Brand-name Prozac can cost more than $100 a month, but most vets now prescribe fluoxetine, a monthly regimen of which can cost pet owners a few dollars a month to about $20, depending on the dosage.
Bain is wary of medications. “Drugs don’t work that easily,” she said. “And they don’t work without behavior modification.”
Much of what animals do, Bain said, is normal, just unacceptable -- a result of owners incorporating their pets into close urban quarters. “Breeds of animals have not changed that much in 20 or 30 years, but human society has,” she said.
“What have we done to our animals? In the last 30 years, we’ve kept them inside, we’ve made multiple-cat households. A border collie, 20 years ago, was living on a ranch in Colorado, and now he’s living in downtown San Francisco. So he can’t do his typical behavior.”
Moustafa Seoud, a veterinarian for 17 years, sees drugs like Clomicalm or Prozac as “an easy way out.” Seoud, who practices at the Laurel Pet Hospital in West Hollywood, relies on massage, acupuncture and homeopathic treatments. “Homeopathic flower essence works well for cats with different problems -- stress and anxiety and kidney problems.”
He dispenses different types of remedies for different problems: “Camomile is calming; Ignatia for grieving; Nux Vomica for nervousness.” One of Seoud’s clients said that one time, as he prescribed a homeopathic remedy for her withdrawn cat, he popped some of it into his own mouth and declared: “You can take it too.”
Conventional drugs seem to be working for Sam, the dog with the bad case of separation anxiety. Weber tells Sueda that Sam has been fine when she’s left the dog alone for a few hours during the day. And Sam has stopped following Weber around the house constantly. “She’s just calmer,” Weber said.
“That’s what we’re aiming for,” Sueda said. “A general, overall sense of calm.”